1) Do you think Rogers assertion that even a small gesture like a frown from a child's parent is enough to cause the child to feel less loved is accurate? If so, in what ways could a parent discipline their child that might not cause them to feel less loved? Do you think Rogers would tell parents to simply practice a kind of CCT for childrearing, in other words making them the agents of change rather than the parent imposing "conditions of worth" on them? (Prochaska & Norcorss, pp. 132-133).
2) Miller claims his Motivational Interviewing is "Rogers in new clothes," but this seems a bit simplistic. To be something in "new clothes" would imply that you are nearly identical but just using different words or styles to do the same thing. MI seems very useful, but it does not seem to me to be nearly identical to Rogers. While empathy is a major concern of both as is the use of reflective speech, the fact that it is admitedly "directive" is a definite area of divergence. More importantly, the concept of "developing discrepancy" as a goal of the therapy seems very un-Rogerian. As described by the authors, it seems that discrepancy is the just the client trying to achieve the conditions of worth, not rid themselves of them and self-actualize as Rogers would have wanted. For example, MI was developed for addictive behaviors, but heavy drinking is likely pleasurable for the drinking person at least while they are doing it. Their desire to quit would therefore be motivated not from within, but from their recognition that important relationships in their lives are falling apart due to it. In that case the "more ideal self" would be just another way of saying a person who lives up to their conditions of worth. (Prochaska & Norcorss, pp. 147-148).
1)One aspect of Roger’s model of therapy is that the therapist should have “accurate empathy”. This means that the therapist tries to understand the client as if it were their own experiences. The therapist often acts as a mirror for the client. In class, we discussed how the largest part of therapy is who we are or the person of the therapist. Putting these two ideas together, there must be a balance between maintaining our person and also reflecting and empathizing with the client’s emotions. What exactly does this balance look like? (Norcross and Prochaska, 6th edition, pg. 143)
2)I think that Norcross and Prochaska make a valid point when they discuss how client-centered therapy disregards culture and the surrounding environment. Individualism is a large part of the American culture. However, we might be seeing clients that come from a religious or cultural background that does not place high value on the individual. How can we use Roger’s idea of person-centered therapy while still taking into account culture and environment? (Norcross and Prochaska, 6th edition, pg. 161-162)
1. Rogers (1961) highlights his personal experience as the most authoritative method of truth discovery: “Neither the Bible nor the prophets- neither Freud nor research- neither the revelation of God nor man –can take precedence over my own direct experience” (p. 24). Experiences are interpretations of events filtered through the grid of one’s worldview – shaped by personal beliefs, culture, environment, etc. If I relied on personal experience as my most authoritative way of knowing, I think I would feel insecure and uncertain all the time. As there are many methods of knowing such as rational discourse, experimentation, hermeneutics and special revelation from God (Entwistle, 2004), do you (classmates) give greater authority to any method(s) when seeking or evaluating truth?
References
Entwistle, D. (2004). Integrative Approaches to Psychology and Christianity. Eugene: Wipf and Stock Publishers
Rogers, C. (1961). On Becoming a Person. Boston: Houghton Mifflin.
2. Genuineness, unconditional positive regard and accurate empathy are valuable therapeutic principles. I imagine they are extended with caution and balance, as too much sharing in attempt to be genuine could lead to over disclosure, too much positive regard could lead to a sexual relationship, and continuous empathetic understanding could lead to counselor burnout. The practice of empathetic understanding, regardless of one’s ability to maintain separateness, is emotionally draining work. I am thankful that the Lord renews and sustains emotional strength (Prochaska & Norcross, 2010).
On the topic of developing discrepancy in motivational interviewing, you raise an interesting question. Prochaska and Norcross (2010) state, “the person-centered therapist is, in fact, quite directive, but in a subtle and noncoercive style, and only responding to information already in process in the client” (p. 139). As addictive behaviors and addiction-related experiences can be quite threatening for clients to address, could the principle of developing discrepancy be viewed as an extension of the Rogerian therapist’s task to “move the work ahead by empathetically organizing the information from a client’s experience in a concise and accurate manner (Prochaska & Norcross, p. 139)?” Perhaps developing discrepancy could be viewed as another means through which the therapist communicates understanding to encourage client self-exploration (Prochaska & Norcross, p. 141).
1) Through the reading I realized that modern educational counseling curricula places great emphasis on Rogerian technique, namely the use of unconditional positive regard as a rapport-building skill (Prochaska & Norcross, 2010, p. 132, 136). School counselors are required to view all of their students with unconditional positive regard as it is listed as one of the key foundational attributes of a professional school counselor in the ASCA (American School Counselor Association) national model.
2) During a discussion this morning at the breakfast table, my husband, Ed mentioned how physicians use MI (motivational interviewing) for addressing addiction issues and in particular smoking cessation. I found this interesting due to the statement that though MI efficacy in substance abuse is sound, it has not been proven as effective in smoking cessation (Prochaska & Norcross, 2010, p. 150). If we assume the studies mentioned are accurate, why would modern medicine utilize the MI therapy model?
I too bristled while reading Roger's (1961) statement that he "could trust his experience" in regards to his practice of therapy and career choices (p. 22). Though I believe very much in the value of experience, I agree with Melissa that if we do not rely on God's wisdom for guidance and ultimately believe in His omnipotence in our lives, we are doomed for disappointment at least and ultimately failure. Rogers further states his case by saying that "experience, for him, is the highest authority" (p.23). This proclamation led me to believe that not only did he leave seminary and theological study but perhaps he also doubted the validity of religion as a whole?
1. The text mentioned that clients have a tendency to share feelings or emotions of the past rather than what is there at the present time. As the client becomes more comfortable with the therapist (which is achieved through the as therapists show empathy, unconditional positive regard, etc), the client will slowly begin to express what they are feeling at that moment. I think as Christians, we are caught doing this within our own communities. We share or discuss what sin we struggled with a few months ago or what family issues we had a week ago. We often find ourselves sharing how God brought us out of the sin or how we successfully solved the family issues we had dealt with? It’s so much easier to share what we’ve already gone through because it shows people our strengths and our ability to overcome struggle, rather than allowing our community to enter into the pain we feel at the current moment. We don’t want to look weak or sometimes don’t even want to receive the help. Knowing that I personally get caught in this, I think it will allow me to be more patient with my client as they take time to move from sharing past problems to expressing current emotions. (Prochaska & Norcross, 151).
2. I find it interesting, and a bit ironic, that while the client-centered therapy model emphasizes selfhood and puts high value on individualism, Rogers “rarely managed to individualize his therapy to fit the particular client!” If this model asks us to show empathy and unconditional positive regard towards our clients, what should our attitudes be in order to ensure that what we say or how we help them is unique to each individual? (Prochaska & Norcross, 164-165).
Sarah Moon, October 4, 2009.
Response to Jay Wellman:
I agree to a certain extent that even a small gesture like a frown from a child’s parent is enough to cause the child to feel less loved. It might not be from just that one incident, but the effects of one frown here, an angry tone of voice another day, and a look of disappointment a few days later, all can contribute to make the child feel less loved. I believe that children are affected by their parents’ body language, tone of voice, and actions. Even if the parent’s intention is not to devalue their child, parents are emotional, imperfect human beings that make mistakes. However, I think that the difference between a child that doesn’t feel loved at that particular moment and a child that never has felt loved by their parent is not determined by just one frown. It is determined by the consistent or lack of consistent affirmation and love shown to the child.
1. Self-esteem is centrally necessary to Rogers’s theories; he emphasized increasing the facets through which one can feel positive self-worth rather than trying to increase self-esteem (Prochaska & Norcorss, 141). In doing so one learns to value emotions, virtues, character traits, and personality traits that were initially thought to be unacceptable and shameful. Is Rogers advocating a “truth is relative” approach? Or is he arguing that some emotions or character traits are not inherently immoral but rather socially unacceptable?
2. After reading the quote, “Acceptance of self begets control of impulses” (Prochaska & Norcorss, 143), I wondered if this was a simplistic solution to the behavioral issue of self-regulation. Having experience with anorexia, I have been told that the need for control triggers the behavior. A cause of this need could be the pressure to conform to externally imposed ideals (Prochaska & Norcorss, 143); however, simply learning to accept oneself does not necessarily mean that the person automatically learns self-regulation. While it does deal with a root of the problem, “teachable behavioral techniques have been found to be more effective” in correcting the behavioral issue (Prochaska & Norcorss, 150). This gives the therapist and client more tangible tools with which to learn self-regulation.
I do not believe that a frown is capable of making a child feel less loved. A child would be severely insecure if a frown indicated a parent no longer loved them. Lovingly disciplining a child promotes healthy development Baumrind found that children whose parents used an authoritative parenting style were happier, more self-confident and better adjusted than those whose parents used an authoritarian or permissive style (Baumrind, 1967). Also, as a side note, it is important that children assimilate some of the (imposed) values of the society, otherwise how will they know how to function within it?
References
Baumrind, D (1967). Child care practices anteceding three patterns of preschool behavior. Genetic Psychology Monographs, 75(1) 43-88.
1) An aspect of Person-Centered Therapy that really resonated with me was Roger's emphasis on motivating factors behind our behaviors and attitudes towards ourselves. I found this to be consistent with Christ's emphasis on the heart rather than on our ability to live up to certain standards. Since we all "need to be prized, to be accepted, to be loved" we also tend to "act in accordance with the introjected or internalized values of others" (Prochaska & Norcorss 6th Ed, pp.138-139). A lot of times these conditions of worth are placed on us by our pastors, spiritual mentors, congregations, etc...leading to a Pharasaic kind of incongruence. In addition, Rogers spoke only of the conditions of worth placed on us by our parents but there are conditions of worth in every arena of life--sports, school, media, etc...
2) I have been reading a book called "The Art of Intimacy" by Thomas & Patrick Malone (1987) and they mirrored Roger's idea of unconditional positive regard in their work with alcoholics. They found that the therapist and the spouse of the alcoholic must accept the alcoholic both when he or she is sober and when he or she is intoxicated for there to be real and lasting change. This was the exact approach that Prochaska & Norcorss advised for the therapist working with Mrs C (6th Ed., p. 164). Mrs C needed to be loved wether she washed or didn't wash. Again, I find this to be the way that Christ came into the world. "For when we were still without strength, in due time, Christ died for the ungodly." (Rom. 5:6, NKJ).
It is amazing how much of psychological theory and practice has been emperically proven to be ineffective and yet used widely across the nation. In an article I read for our regression class, I found that residential treatment centers for delinquent youth utilize a point and level system for behavior modification that has been unanimously proven to be completely ineffective! I think this may be partly because a newer and more effective model has yet to be developed.
1. On page () it was commented that intimacy is therapeutic and therapy is intimate. I was just musing about the implications of that. By now we have all heard a million times about how the intimacy of therapy can go awry (by the therapist sleeping with and otherwise taking advantage of the client) but I was also thinking about how outside of the therapy session this could have horrible implications for a client. If intimacy is therapeutic, then there are healing aspects to say, having a close friend. There are also then, the friends that expect the people close to them to provide a type of therapy that leaves the friendship lopsided, less intimate on one side than one the other. How, as budding therapists, could we prepare clients to not expect that their friends will have the energy or the knowledge to provide therapeutic intimacy for them, and should we think about such a preparation? (Prochaska & Norcross pp. 150)
2. If "meaning emerges from the process of actualizing our tendencies to become all that we are intended to be," and people "with the belief that there must be something more to life than natural living have probably not experienced all that there is to their lives," then there has to be some kind of reconciliation between the person-centered approach and the faith of clients who would seek this approach to help them heal. I suppose that one could say the statement does not apply to people who believe that there is some kind of afterlife which is better than the life here, and that actualization in the sense of being completely satisfied with one's state of being is a slim possibility. I really resonate with much of the person-centered approach, and I think it valuable for people to realize that there is meaning to their current existence, but the way that this is phrased makes me struggle a little. Does anyone have a more eloquent way to rephrase this than I do? It seems that words are escaping me. Prochaska & Norcross pp. 152)
Response to Melissa:
When seeking or evaluating truth, I do allow for methods other than my own experience to guide me. Experience is so powerful because in a way, it is all we really know. The emotions, the memories, the sensations, all of them are compelling, and certainly they play a huge role in my decision making and thought processes; however, I don't think that experience alone is enough. In light of the sin nature we have, in light of findings about the fallibility of memory, and so many other factors, but especially because of my innate fallenness, I don't think I could let experience trump everything. I guess I use a combination of methods, so I would not agree with Rogers, but that combination varies on the circumstance.
I think to be fair to Rogers, he is claiming his experience is the most authoritative due to its immediacy. He has all the relevant knowledge anytime he conducted research or spoke with a client and does not have to question how information was gathered. He also clearly states his experience is fallible but one of the advantages is that his own experience is easily corrected. I think the way Rogers means this it is actually commonly how both laymen and scientists behave. Experiments are replicated to try and achieve similar results, in part, because until doing it themselves, scientists cannot be sure all variables were properly controlled. Thus their direct experience is more authoritative than the original researcher. In a spiritual context, one can preach to you the merits of, or problems with, the gospel, but your own experiences are what are going to govern your decision making process on whether or not to accept it.
According to Rogers and Standal, we “actually learn to need love”. Yet studies have shown that infants who don’t receive enough love or affection will die. Is it possible that we learn to need more love as we grow? Or do we just learn to need a different kind of love? (Prochaska & Norcross p. 143).
Roger’s idea of an ideal intimate relationship includes “unconditional prizing, accurate empathy, and interpersonal genuineness” (Prochaska & Norcross p. 154). If a client is struggling with relationships and is met with the unconditional positive regard of a great therapist, will this affect his/her thoughts on what a good relationship is? For example, say a woman is going to therapy because she and her husband are struggling in their marriage. If the therapist is perfect (in terms of Roger’s ideals), will the client become disillusioned and be frustrated that her husband doesn’t come close to having the therapist’s personal skills? Might this possibly make the marital problems worse instead of better?
(In response to Ashley) One thing that might help our clients is to teach them about healthy relationships. Perhaps we could explain to them that therapists are different from friends because they get paid to help. Friends are typically willing to be empathetic listeners too, as long as they are “paid” by getting the same treatment in turn.
One concern your post brings up is that sometimes we (the budding therapists) might have the opposite problem- friends who want to leach empathy off of us. Might we become so accustomed to giving and not receiving in relationships that we forget what real intimacy is? I’m guessing that the friendship network of a therapist becomes vital early on in his/her career.
1) Upon reading that a "meta-analysis indicated that the apparent effectiveness of client-centered therapy was largely based on the treatment of problems that occur in academic settings" and that generalizability cannot be made beyond academic problems, I could not help but wonder why/how Rogerian CCT gained such popularity within non-academic settings? Additionally, given its efficacy when dealing with problems in academic settings, what is it about CTT that makes it particularly beneficial within that context?(Norcross & Prochoska, 162).
2)In light of my previous question, I was wondering if perhaps the finding that "one type of outcome measure on which CCT demonstrated higher change than a number of other orientations was in self-esteem..." might serve as a potential explanation for the success of CCT when addressing problems in academic contexts. For it seems reasonable that self esteem might play a significant role in the manifestation of problems within such settings.Then again, what is meant by "problems that occur in academic settings"?(Norcross & Prochoska, 162).
As far as love goes, I think it is possible that Rogers is referring to a different kind of love than that studied with infant mortality vs. thriving research. Rogers seems to conceptualize love more as approval and affirmation that one is loveable/loved. Where as, if I recall correctly from the infant studies, love had more to do with touch and general human contact (affection) rather than the affirmation or disapproval of the infant's behaviors or self. You do make a good point however, that perhaps what one interprets and internalizes as love may change throughout one's development, thus, we may subsequently "learn" to need love in a different or new way after progressing from infancy.
Response to Sarah’s second question: Sarah, I think what you are saying is that there is a contradiction and I agree with you on this. Dr. Dueck briefly mentioned this in class today. I think that therapy needs to be individualized especially in a culture we live in. First, our culture places a high value on the importance of the individual. Second, we all come from different cultures, ethnicities and religious backgrounds. We must understand our client from their cultural context. Thus, therapy needs to be individualized.
1) Rogers was heavily influenced either positively or negatively by Protestantism. Perhaps his theory of unconditional positive regard arose from the concept of God's grace in Protestantism. It is similar in a sense that a person's value is not judged by what he or she possesses or does, but instead, just the existence of a person alone is of great value (Prochaska & Norcorss, pp. 133).
2) I do not really agree with the vulnerability part of Roger's necessary and sufficient conditions for therapy. He states that "vulnerability to anxiety is what motivates the client to seek..." therapy. Since most people dislike the feeling of being vulnerable, it makes sense that the client is willing to seek therapy to prevent oneself from being vulnerable to anxiety. However, wouldn't seeking therapy make the client replace his or her vulnerability to the therapist instead of the feeling of anxiety? If the client is wanting to get rid of such feeling of vulnerability, wouldn't the client also be sensitive enough to know that they will make themselves vulnerable to the therapist? (Prochaska & Norcorss, pp. 136)
Response to Lauren Brighton's post: From my experiences, I find that I often stress my thoughts and feelings more so than that of others; I have a tendency to emphasize myself more than what is necessary. For a therapist, by affirming the client and asking certain question that helps the client to reflect upon his or herself, instead of assuming what the therapist thinks the client feels, it may be possible to establish that balance
1)I've always agreed with a lot of the critiques against client-centered/person-centered therapy, namely those listed from the integrative perspective. How are we to use this therapy with clients that have been abused or clients with major personality disorders? That then leads me to ask, as psychologists, do we need to research whether some therapies are only meant for some clients while others are best suited for others? (Prochaska & Norcross, pp. 165-166)
2)Chapter 5 tells us that Rogers seemed to agree with his student, who said that the need for love, or to be loved, is learned. As a Christian, I would argue that the need to be loved is inherent in all of us because God created us so that we may seek Him, and He is love. (Prochaska & Norcross, pg. 143).
Nikki Frederick, 10/05/09
In response to Jay's first post: As a parent who of course struggles with trying to understand the healthiest and holiest way to discipline children, I would say that it depends on why you're frowning and the context in which you're doing so. God clearly gives us directions as to what is right or wrong, yet also gives us free will and has patience with us. I think a CCT with children may be a great tool if used correctly. Allowing our children to make positive changes and choices, yet loving them regardless, is probably one of the best things we as parents can do for our children.
1) The more I learn about how Carl Rogers revolutionized the field of psychotherapy, the more amazed I become by what a difficult craft his principles must be to practice. For example, several of Rogers' key principles are: Unconditional Positive Regard, Accurate Empathy, and Perception of Genuineness. I find this to be an extremely difficult juggling act. How can a psychotherapist have unconditional positive regard for a client (no matter what they bring to the table) while still maintaining accurate empathy and genuineness? "...the therapist must be seen as genuine and not just playing a role" (Prochaska & Norcross, 137). Becoming a therapist that could sit across from someone who confesses to something vile and disgusting while maintaining a genuinely nonjudgmental empathy is something that I imagine will not only draw on my training in psychotherapy, but my training as a disciple of Christ.
2) William R. Miller's motivational interviewing is very powerful in my estimation. To me, the essential ingredients are the key questions and reflective listening. While maintaining the warmth and empathy as in Rogers' person-centered style (Prochaska & Norcross, 147), the therapist goes an extra step and puts the ball in the client's court so to speak. Without antagonizing the client, the therapist asks questions that empower the client to think deeply about issues and perhaps move toward a resolution which may result in progress. This seems like the type of collaborative relationship that could make for some very quality psychotherapy.
Response To Lauren's #1...
Lauren, I thought the same thing. I am curious as to how this balance can take place. It seems like quite an art form to be able to mirror someone and allow them insights into their own feelings and emotions, while also accurately empathizing with them. Perhaps I am misunderstanding where the balance lies or if they are even taken as literally as I see them, but it seems impossible in my first year PhD mind. I guess that might change with more training and experience...
1)"The person should be the center of his or her meaning, rather than having a meaning imposed by other individuals or society as a whole." (Prochaska & Norcorss, 145).
This statement brings up a couple of issues. First, it seems nearly impossible to apply this approach to the religious who believe in a higher being who provides meaning. Second, even non-religious people who intentify with a culture or community would find this hard to swallow. Finally, this view is at risk for doing the same thing that it seeks to avoid: imposing a self-centered meaning onto the individual.
2)Two of Roger's six requirements for a constructive relationship are genuineness and unconditional positive regard. What happens if the client is doing something that is repulsive to the therapist? Even if the therapist can hold the two in tension (that is, respect and care for the client but also disagree with his actions/thoughts), what if the client doesn't believe it? When is it time to refer the client to a different therapist? (Prochaska & Norcorss, 136).
David Choi, October 5th, 2009.
Response to Rachael Wittern:
Your second point is interesting and seems to echo a criticism from a psychoanalytic perspective (Prochaska & Norcorss, 154). I think the chance is certainly there, but hopefully, the marriage is based on more than positive regard. There should be things (both mundane and special) that the couple loves about each other that go far beyond what the therapist can offer. In addition, one would hope that the therapist was ethical and professional and did not try to woo the client. But it could happen.
1)Prochaska & Norcross said that Carl Rogers surprised them with his candor regarding his ability as a therapist, to be both genuine and nondisclosing. He said that over the years of first working with psychiatric clients and then with growth-oriented groups, he had come to see that his model of a therapist as reflective and nondirective had been very comfortable for a person like him. He said that he had been rather shy and therefore non-disclosing. they also state that right up until his death, Rogers was realizing more fully in psychotherapy and his life, the genuineness he had always valued but never actualized. That being said, do you think if Rogers would have been in therapy earlier in his life and had fully actualized his own genuineness would he have approached the idea of Person-Centered therapy in the same way? If not, what elements do you think would be different? (Prochaska & Norcross, pg. 131)
2) I disagree with the person-centered therapy to impluse control. I think it is over simplified and generalized. It states that once people feel good about who they are and are not under constant stress to be what others want, they will not resort to overeating, drinking, or smoking to feel good for the moment or reduce stress. Acceptance of self begets control of impulses. But what about the scenario where the stressor is ones environment and not necessarily connected to the expectations of others? Also, how should impulse control be addressed if the person does not struggle with low self efficacy? (Prochaska & Norcross, pp.145)
Stephen McGee, October 6, 2009
(Response to Samuel's post) I too have a bit of a problem with Rogers' view of vulnerablility regarding necessary and sufficient conditions. Although I understand that he regards it as a catylist that helps push someone toward therapy, they are exchanging one form of vulnerability for another. The client has to remain in a state of vulnerability with the therapist in order for the therapy to be effective.
1) Miller's motivational interviewing is a strange thing (Prochaska & Norcross, pp147-150). The strange thing is that it works. At my last job, we would use it to help chronically mentally ill people develop their own motivation to do things in their lives, like shower, or take their meds. While it was personally frustrating at times to deal with client's ambivalence about simple things like teeth brushing or cleaning their apartment, when they decided to do something, the process worked.
2) I am wondering if it is possible to ever truly be self actualized (Prochaska & Norcross, pp147-150). The human being is such that our potential grows as we develop, so that what was our best one day becomes our plateau the next. Is it possible that we as always changing and improving individuals must (to steal a phrase from Winicot) settle with being "actualized enough?"
3) (In Response to Ashley Wilkins) I think the need to reconcile people's faith with the modality of treatment comes about naturally. Because faiths are human creations with divine origins, at some point humans end up making mistakes within the faith. Pastors hurt parishioners, Sunday School teachers embarrass students. What needs to happen for reconciliation is to understand that the way that the representative of the church has hurt them (by harming their self image in the person-centered view) may not be who they really are. Also, I think it is important that your beliefs are separate from the client, so that you can avoid making the same mistakes and become an enabling agent who prevents self actualization through dogmatic adherence to church law.
1. “The empirical justification for therapist self-expression is the discovery that therapists who speak genuinely out of their strong feelings tend to encourage and liberate clients to express their own emotional experiences” (Prochaska & Corcross, 141). This sounds great in theory, but potentially inconsistent in application. Considering diverse backgrounds and various cultural norms, I would imagine all clients would not always respond positively to their therapists expressing their strong feelings. I would think the effectiveness of this approach would vary greatly with the degree of incongruence within the client.
2. “The problem is not that we have too great concepts of ourselves that we cannot live up to; the problem is that our concepts of ourselves are too meager to let us be all that we were born to be” (Prochaska & Corcross, 142). Here, Rogers describes how low self-esteem (self regard) develops in people. Basically, our mind creates a “limit” for us as to what we can be or become and that “created limit” is nowhere near our actual potential. I find this so interesting because I think we sometimes put a limit on God and what He can do.
Response to David Choi:
Very good point David. It seems incongruence may develop in a therapist that is exhibiting unconditional positive regard toward a client that that they perceive as repulsive.
1) I was fascinated by the description of the therapist as a surrogate information processor, helping clients to focus in on and effectively process threatening feelings (Norcross & Prochaska, 2003, pg. 149). In my past studies of person-centered therapy I have never come across such a clear description of how the therapist guides the process of therapy without determining what will be discussed (the content). This helps illuminate for me the therapist's role, expanding it beyond that of a completely nondirective mirror. It seems that in this way the therapist is subtly directing the flow of therapy toward healthy processing, without imposing expectations or confinement upon the client.
2) I also really enjoyed the Rogerian perspective on self-esteem/self-regard (Norcross & Prochaska, 2003, pg. 153). Low self-esteem is seen a result of a narrow self-concept, and interestingly, the aim in therapy is not to increase a person's sense of self-esteem, since this would merely lock the client into a pattern of attempting to actualize a self-concept that is false or limited in the first place, but to expand the individual's conditions of worth, in essence revolutionizing their self-concept in order to truly accept and value who they are and can be as opposed to who they have felt they should be.
Response to Amber:
It's funny that you mention that about our educational system's focus on Rogerian approaches - I was thinking about that throughout the reading as well. I remember learning the term "unconditional positive regard" when I was a very young child, because it was one of the core values of the school district and was taught in each classroom as a way of relating to fellow students, teachers, etc. I think that being taught from an early age to see others from that perspective can be extremely formative and beneficial.
1) Roger’s views on psychopathology reminds me of concept of the reciprocating self (Balswick, King, Reimer, 2005). Individuality is just as important as being in relationships with others; they are reciprocal. Does Rogers place too much emphasis on actualizing forces as motive for a complete self? I think individuality can serve to enhance relationships. Perhaps it does not always serve the individual only (Prochaska & Norcross, pp. 131-133).
2) I wonder how it plays out to always be able to provide unconditional positive regard for a client, even when the client pushing the therapist buttons or even talking about actions that or negative, maybe even dangerous or illegal. I found it difficult to stay “person-centered” women coming into the shelter I worked at would blatantly lie. How to you continue offering empathy and genuineness in this situation? (Prochaska & Norcross, pp. 136-137).
Response to Sarah’s 2nd post:
Your question brought me to Dueck’s integration lecture yesterday where he modeled asking about background and culture of a person. I think it’s important to always remain open to new ways of looking at the world; to especially have a basic understanding of the differences between communal and individualist cultures and what are bias might be toward one or the other.
"Roger's (1961) ideal for the good life is found in a fully functioning person" (152). The concept of the "fully functioning person" seems synonymous with the essence of a whole person. I find it interesting that Rogers suggests that trust is a significant element to a person's functioning. It is the idea that trusting every experience to be a transformative event that leads to awareness and direction in life. The fully functioning person copes with each experience and can accomplish a "good life" because of their ability to effectively think and act out of the true self. As a therapist, what does this fulfillment look like? Is it perceived as a piecing together of of segments of the self, a realization, a solidification, etc.?
In person-centered therapy, I think a large part of it is facilitating an environment for self-actualization and fulfillment to happen for the client naturally. The process includes the clients themselves to become aware of their uniqueness and individuality. The attitude we may want to have is that of recognizing the experiences of the person and helping that shape their development.
I am wondering if motivational interviewing is shown to be as effective or more so than 12 step programs, why is it not the primary method for treating clients with alcohol dependence/abuse issues. I remember hearing people say that one of the helpful things about AA groups is that the individuals involved have been there and call people on their denial behavior. In contrast, MI "carefully avoid[s] the classic confrontation". This has apparently been shown to be particularly useful for treating resistant clients (Prochaska & Norcross, 2007, 148-150).
If I understand your comment, you are wanting to learn how to maintain unconditional positive regard while continuing to be genuine even when someone shares something you find appalling.
I conceptualize this by cognitively separating behavior from the person. You can do something bad/evil without it being representative of you as a person. Therefore, in theory, it makes sense to be able to maintain unconditional positive regard for your client while trying to understand what has contributed to them behaving in this way.
1)The author contends that Rogers seems to agree with his student Strandal that we “need to learn to need love” (Prochaska & Norcross, p. 138). While I actually disagree that we to learn to need love, I believe like the author states earlier that the need for love is universal and perhaps we have to recognize that we need love. I wonder, why is it that we cannot recognize that we need love? Does our culture so emphasize independence that we consider love as a competing force for individuation? Do people of other cultures need to learn to recognize their need for love also, or is this more of a Western issue? Or is it more a spiritual issue—that when we learn to recognize our need for love we make roads towards connecting with God, who can ultimately provide us with the level of love our soul craves?
2)I’m interested in the difference between process research and outcome research. It seems Rogers focused his research on the process of psychotherapy. How are both of these used effectively to improve therapy? Both seem important, how the process is conducted and what the outcomes are. And, of course not only the short-term outcomes, but the long terms ones as well. I find myself wondering what sorts of parameters he used to evaluate how the relationship was between the client and therapist. (Prochaska & Norcross, p. 154)
Response to Ashley: Ashley, I appreciated your comments on the intimacy outside of therapy. I was considering some similar ideas of what Rogers work implies outside of therapy as I was reading this chapter, for example when the author states, “[Carl Rogers’s] system suggests that anyone who is congruent, whether a peer counselor or paraprofessional, can do effective psychotherapy with all patients and problems, without necessarily having any knowledge about personality or psychopathology.” (Prochaska & Norcross, p.162) A lay person has a lot of power in Rogers’s view. I wonder, in response to your question, how might we be able to encourage clients not to expect too much of friendships, but also help them choose different relationships which will give them different pieces of what they need so they can build healthy and sustainable social networks, intimacy, and positive self regard?
1) The book describes the therapist work as "surrogate information processor" (Prochaska & Norcorss, p 149). I am a verbal processor and I need to get my thoughts out in order to see them. I need an surrogate processor, a person to create the space in which i can safely view my thoughts and reactions. Once this space is created you can begin to see different aspects of the situation. after hearing this description in our reading, me and my inclinations just clicked. so commenting on Lisa's post. . . i agree lisa, that phrase just clicks and makes sense. and in terms of how you called it a little more directive then the mirror. . . i think instead of being directive, it more or less opens the door allowing them to process, because the threat is less? maybe not.
2) i have never had a class on these things before, so it is my first round of hearing this information. I got really confused when the chapter spends its time describing the client centered therapy, and our class will focus on it, but at the end of the chapter (p163-166) it critiques the theory showing the flaws and making it seem as if this theory should be utilized. how do you weigh such critiques? is client centered therapy not reputable?
1) I find extremely interesting the overlap between the message of Jesus Christ and Roger's theory of counseling. Granted that Person Centered Therapy focuses primarily on the individual receiving unconditional love rather than giving and receiving, but nevertheless the fact that the therapy type concentrates on unconditional love at all is shocking to me (Prochaska & Norcross, 2003, 147). Now that I say that, though, I wonder how this plays out in the room. Does this mean that a therapist should approve of everything a client thinks/does, or that the therapist should simply express care towards the client without "approval?" Can anyone make sense of that?
2) I do struggle with the idea that client-centered therapy may take years to reach any sort of conclusive "ending point" (Prochaska & Norcross, 2003, 158). One of my major concerns is that within a managed-care setting such as much of the United States, open-ended treatment durations are unlikely to receive recognition as viable solutions to mental disorders. However, perhaps client-centered therapy will be better implemented for those clients merely looking to focus on self-esteem and not treat a major mental illness. That is what the therapy has been shown to be most effective for anyways (Prochaska & Norcross, 2003, 162).
If I am not mistaking my facts, I do believe that the consensus of the research suggests that women experiencing marital problems should NOT attend individual therapy with a male psychologist. The statistics show that she is actually more likely to ask for a divorce at the end of the counseling regime, than women who seek out a female therapist or no therapy at all. This is a fact that I remember from undergrad, and so I can't give you a citation. Regardless, I found it surprising at the time, and it is certainly applicable for your question.
1)Roger's Person-Centered Therapy is supposedly nondirective because "clients, rather than therapists, direct the flow of therapy" (Prochaska & Norcorss, 5th edition, p.148). The therapist may not direct the topics the client brings up in session, it is still value-laden therapy. Like Dr. Simpson mentioned in class, he gave importance to some topics more than others when he leaned toward the client. The therapist is very directive of therapy through what topics they show the most empathy towards.
2)How does a therapist develop ways to express true empathy to the client? Rogers speaks against "mindless parroting" and "reflection of feeling" (Prochaska & Norcorss, 5th edition, p. 158). In my friendships I tend to show empathy by helping them fully express their emotion and sharing how deeply I connect with what they are saying based on my own similar experience. But the therapeutic relationship is more one sided than a friendship. What is a good way to show true empathy in a therapy setting without too much personal disclosure?
Response to J.B.: I also see the difficulty in expressing unconditional positive regard in therapy or in a friendship. The term reflects the idea of the unconditional love of Christ that covers our all of our sins no matter what we do. But there is a difference between this kind of love and an approval of all actions that may be seen as a sanction for negative behaviors. Somehow their needs to be the concept of repentance paired with that unconditional love or positive regard.
1) I appreciate how Roger so simply yet so profoundly states that the importance of therapy rests on the humanity of therapists rather than their technical skills. From a Christian perspective, sin (the ultimate reason for brokenness and the need for healing/restoration) resulted in SEPERATION, from God and from others. As we are also learning in Life Span Development and in our readings in “The Reciprocating Self”, humanity IS being in relationship with God and others. Therefore, simply by regaining that humanity through the client-therapist relationship, it brings healing and restores that person to a greatly needed resource that we were created to be a part of (fellowship, community), regardless of whether or not that person recognizes Christ (Christ is never-the-less the ultimate truth). (Prochaska & Norcorss, pp. 141)
2) I struggle with the tension in the concept of the therapist sharing his or her own experiences with the client. I realize that sharing is a part of being genuine (unconditional positive regard) and creating that relationship but, of course, the client-therapy relationship is ABOUT the client and FOCUSED on the client, therefore, the idea of the therapist sharing experiences has always created a tension for me. How much and what does a therapist share with a client? Under what circumstances? For what reason? Of course there are boundaries and anything that is shared should be to the benefit of the client, but this concept is still such a gray area for me/a boundary that is hard for me to understand, that I am really looking forward to learning more about this concept and discussing it more in class. (Prochaska & Norcorss, pp. 147 & 152)
Response to Nikki’s comment: I completely agree with you Nikki that people are born with the innate need to be loved. Studies have shown that children and elderly persons who don’t receive love and attention die quicker and do not have high levels of “thriving.” I agree that God created us to be loved because we were created OUT OF God’s overflowing love. When humanity fell, it separated us from our greatest need, which is God, who IS love, therefore we are all continuously in need of love (reconciliation to our greatest need and the source of the image we were made from). I would argue (or would like to dialogue further about the idea) that because of our fallen nature, we must learn to love and be loved, because we have been so separated from our source of love (God), and that our idea of what love is has been so perverted by our sinful nature, that we must re-learn to be in loving relationships with Christ and one another. Perhaps we can understand this Rogerian concept from this perspective?
Response to J.B.’s comment: I am also very pulled in the direction of Rogerian theory because of the aspects of unconditional love, relationship, empathy, and genuineness. I believe these elements are at the core of the relationship God wants with us as individuals and what he desires in our relationships to each other. I think that understanding God’s unconditional love is helpful in understanding how that unconditional love towards the client plays out in the room. I don’t think that unconditional love would be to approve of everything the client says or does, because in certain situations approving of what they say or do would not be loving them (example: the client hurting themselves or others). Love requires having (displaying through action) their best interest at heart. Also, I think that expressing care sometimes means using protective measures for that client and challenging them in certain areas. Love and care do not necessarily mean being non-confrontational. This reminds me of our reading this week in “The Reciprocating Self”, in this weeks chapter it explains the concept of God’s covenant (or unconditional love) towards us. When the authors write that “God’s offer is not contractual; Whether Noah or Abraham accepted the covenant or not, God’s commitment was firm” (pg. 54), this seems to resemble the therapists role, in that, the therapists love (unconditional positive regard) is not based on the actions of the client. However, the authors go on to say that “the potential benefits or blessings [the covenant] provided were conditional….[they] had to agree to fulfill their end of the bargain” (pg. 55). In the same way, the therapists actions towards the client change based on the clients actions/willingness to engage in the process even if the therapists unconditional love/positive regard remains the same towards the client no matter their behavior.
1) Rogers believes that there is no true reality and rather that reality is what we experience. With this as a basis, he forges ahead claiming all are born with an "organismic valuing" system. He then assumes that these systems are similar in all people. With no ultimate truth, how can Rogers claim that a somewhat universal valuing system exists? Would this valuing system not change according to culture?(Norcross & Prochaska, p. 138)."
2) In the therapeutic relationship, Rogers states that genuineness is necessary in the therapist. I believe that this is important, however, I believe genuineness requires a good level of self-awareness. Since we change throughout life, how do we, as therapists, remain self-aware? Do we continue seeking psychotherapy for the rest of our careers, or do we learn to be self-intuitive? If so, how would this look? (Norcross & Prochaska, p. 142)
Client-centered therapy is just one approach to psychotherapy. Many different forms exist such as cognitive behavioral therapy, psychoanalysis, etc. Many approaches have great parts, but at times, fail as a whole. By learning about the successes and failures of each approach, we can better integrate these strategies into our own form of psychotherapy.
In response to Nikki's first question.
I also tend to critique aspects of this approach. I think as therapists, it is necessary that we learn the most we can about different approaches to therapy. Every person is different, and therefore, the same approach will not work for all people. I think there are good qualities in this person-centered approach. We should take the good qualities and use them with our clients when appropriate.
1)Roger's believed that all human interactions should be "humanized." I wonder if this desire to make a change is simply a call for the importance and healing power of community rather than the growing individualism present in our western culture. Would religious therapists (who value a faith community) then be better at utilizing this therapy than non-religious therapists? (Prochaska & Norcorss, pp.151). 2)One of the conditions of Roger's therapy is Genuineness, meaning that the "therapists are freely and deeply themselves." However, another condition is Unconditional Positive Regard. How does a therapist justify the treatment of a client that they do not personally like? Is it assumed that therapist practicing this therapy will genuinely like every client they encounter?
In response to Lauren's comment: I was also wrestling with the genuineness aspect of Roger's therapy. I wonder if the struggle is a part of what makes a therapist a good therapist: someone who can continually ask themselves, "How do I present myself genuinely and relate with this client? How can client an environment to allow this client to be more genuine in who they are."
n response to Jay's comment about directiveness and discrepancy in Motivational Interviewing:
I think the distinction of Motivational Interviewing as directive can be misleading. I would revise that statement within the context of this chapter that it is "relatively directive" as compared to Roger's Person Centered therapy in which clients can choose to focus on any subject at any moment during the session (pg 144, Prochaska and Norcross). Where Motivational Interviewing requires that the therapist focus on the area of behavior change, such as addiction, health behaviors, or other dangerous behaviors, the therapist's attitude still retains the non-directive attitude of the therapist. For example, in response to a client who says, "Drinking a six pack before work might be harmful for others, but it actually helps me stay on my A game, so really, it's better for me to drink while I'm at work than not drink"....the directive therapist might say, "you might feel great, but how do your co-workers and boss feel around you at work?". The non-directive therapist might say, "you feel it's okay for you to drink before work...". Finally, the Motivational Interviewing therapist would say, "It's hard for you to believe that things would improve for you if you stopped drinking at work...". The difference is that while being non-judgemental, and accepting of the client's point of view, the therapist is joining with their point of view and taking their reflective statement one step further towards change. In this example, the therapist is taking the client from feeling comfortable drinking on the job to how they would feel not drinking on the job. Whereas the non-directive (Person Centered) therapist would simply reflect on their feeling (you feel okay about drinking on the job....) without directing their statement towards change. Compared to the classically directive therapist who wants to point out that drinking on the job is negative for all at the workplace, including the client, the motivational interviewer develops discrepancy that already exists for the client: "why is something that is harmful less harmful for me?". Though developing discrepancy seems like the therapist is challenging the client, when done correctly, it is really allowing the side of the client who feels that drinking at work is harmful challenge the side of the client who feels they still need to.
I think the critique of person centered therapy is interesting in pointing out errors in testing its effectiveness, specifically failing to control for a placebo effect. (pg160 Prochaska, Norcross, 2007). I think this could be that it is hard to encounter a therapeutic approach that does not entail at least part of the components of person centered therapy. For example, which therapeutic technique does not utilize some form of warmth and empathy? It is easy to see PCT as obvious, or at least more of a basic framework for all therapy in its utilization of empathy, allowing the client to define their problem and focus issues, and reflecting their truths; however, I think the truer critique is that perhaps PCT is not defined enough to be tested. Specifically, how is it determined that the therapeutic techniques really are Person Centered? It is easy to believe that you are being non-directive at the same time that your attitudes and beliefs are showing through your body language, tone, or focus. So the question becomes, how can we make PCT reliable and replicable so that we can test its effectiveness?
The vignette of Mrs. C (Prochaska & Norcross, pg. 166-167) really struck a chord in me. To see a woman who was cleaning compulsively and nearly rejecting her sick children because of their supposed "dirty" diseased-ness, would be a definite empathy challenge. I think I might be inclined to jump toward trying to deal with a compulsive disorder, instead of empathetically seeing where that may be stemming from. Recognizing where Mrs. C's conditions of worth are clashing and her need to uphold the self-regard she was taught to gain from cleaning is much more important (and probably more effective) than trying to get her to stop cleaning and take care of her sick kids.
2.It was interesting to read the various schools of therapy's responses to Person-Centered Therapy (Prochaska & Norcross, pg 163-165) and to note that the effectiveness of short-term or "brief" series of Person-Centered Therapy has not been studied much (158). Motivational Interviewing seems like a good incorporation of Person-Centered principles. What is the difference? Or are they two branches of the same tree?
In response to Katherine's second query about whether you can be genuine and CC when you may not particularly like a client... As we discussed in class, I think upholding client-centeredness has more to do with valuing the person as a person and taking their experiences and feelings seriously as they feel them. Not necessarily endorsing everything they think, or supporting any emotion they indulge, but rather to genuinely care for them and genuinely listen to where they are coming from. Caring, valuing, accepting the human doesn't necessarily equal liking, endorsing, etc. Afterall, if you didn't think there were any areas of that client that needed growth, why would they be in therapy?
1. I found it really interesting when the author described how genuine intimate relationships are truly rare because of how hard it is to give to others what we are afraid to admit to ourselves (Prochaska & Norcross, 143). Just how we tend to distort our self-perceptions to fit our self-concept, we also can distort our perceptions of our spouse/partner to fit the conditions of what we deem as worthy of our love (Prochaska & Norcross, 143). This is profound because so often we can blame our partner for something they have done when really all they have done is not fit into to our “conditions of love.”
2. The reading made me reflect on how much of our own self-image is contingent on others. Because of our need for positive regard, we shape our image around what earns us a pleasing response, which then becomes an internalized condition of worth. The author mentions that this desire to earn positive regard is so strong that at times it overpowers our innate desire to become actualized (Prochaska & Norcross, 132). It has caused me to reflect on what conditions of worth I have placed on myself as a result of others.
1. I found it really interesting when the author described how genuine intimate relationships are truly rare because of how hard it is to give to others what we are afraid to admit to ourselves (Prochaska & Norcross, 143). Just how we tend to distort our self-perceptions to fit our self-concept, we also can distort our perceptions of our spouse/partner to fit the conditions of what we deem as worthy of our love (Prochaska & Norcross, 143). This is profound because so often we can blame our partner for something they have done when really all they have done is not fit into to our “conditions of love.”
2. The reading made me reflect on how much of our own self-image is contingent on others. Because of our need for positive regard, we shape our image around what earns us a pleasing response, which then becomes an internalized condition of worth. The author mentions that this desire to earn positive regard is so strong that at times it overpowers our innate desire to become actualized (Prochaska & Norcross, 132). It has caused me to reflect on what conditions of worth I have placed on myself as a result of others.
1. I found it really interesting when the author described how genuine intimate relationships are truly rare because of how hard it is to give to others what we are afraid to admit to ourselves (Prochaska & Norcross, 143). Just how we tend to distort our self-perceptions to fit our self-concept, we also can distort our perceptions of our spouse/partner to fit the conditions of what we deem as worthy of our love (Prochaska & Norcross, 143). This is profound because so often we can blame our partner for something they have done when really all they have done is not fit into to our “conditions of love.”
2. The reading made me reflect on how much of our own self-image is contingent on others. Because of our need for positive regard, we shape our image around what earns us a pleasing response, which then becomes an internalized condition of worth. The author mentions that this desire to earn positive regard is so strong that at times it overpowers our innate desire to become actualized (Prochaska & Norcross, 132). It has caused me to reflect on what conditions of worth I have placed on myself as a result of others.
The Prochaska and Norcross text discusses the role of the therapist in helping clients process information with the use of language and symbols that are "active, vivid, and poignant" (139). I think one thing that definitely ties in with this, and which is something we have been discussing in many of our courses the past few weeks, is the importance of understanding the client’s cultural context. By having an idea or grasp of the culture, it enables the therapist to create metaphors and colorful examples that are relevant to the client and allowing the client to feel truly understood. Therefore, I believe that a big piece in using language and symbols effectively, is to first have a fundamental understanding of the culture the client is coming from. (Prochaska & Norcorss, pp. 139).
How much of the therapists empathic feedback is verbal and how much is nonverbal? Is there even a distinction? As therapy is client-led, and the therapist acts as a mirror in order to help the client explore their feelings, how much does the therapist interject their own thoughts? If the therapist is speaking and sharing their thoughts, but only minimally, is empathy then something that is communicated non-verbally in expression? (Prochaska & Norcorss, pp. 136-138).
I agree with Hannah on how conditions of worth are not only placed on us by parental figures, but also by other aspects of our life. For example, our friends, school, significant other, pastor, and the media all place standards on us that need to be met in order to avoid incongruence and anxiety.
In response to Kim: What great integration! (Yes, I just used the buzzword :) I really appreciate how you take Roger’s emphasis on humanity and relate is so clearly to a Christian perspective of sin, brokenness, and healing within the context of therapy. I would add that as we are called to be the salt and light of the earth, that calling can be lived out in the therapeutic relationship by being simply being in relationship with God. The fundamental principles of client-centered therapy, act as tools to aid in this process.
At the outset, person-centered therapy seems elementary, but as I thought more about Rogers' approach of being both genuine and nondisclosing, I realized that this might be more difficult than it sounds. How do we walk that thin line between nondisclosure and genuineness? At this moment, I am having a hard time picturing how that can be done well. I feel that in order to be genuine, one must be honest. (Prochaska & Norcross, p. 137).
"The more conditional the love of parents, the more pathology is likely to develop" (Prochaska & Norcross, p. 139). It seems then that our duty as therapists is as much to work on preventative measures and education for parents as it is to counsel one who has developed pathology due to conditional regard from parents. How, as therapists, can we recognize and live out the duty to preventative care as well as to therapy?
In response to Lauren's first question, I agree that there needs to be a balance. I also wonder when issues of counter-transference enter into "accurate empathy". I feel like that must be a place of such tension, expressing empathy to a client out of your own experiences while not letting those experiences taint the therapy.
I'm the author of Assaulted by Joy: The Redemption of a Cynic, What Women Wish You Knew about Dating, and co-author of What Wives Wish Their Husbands Knew about Sex.
57 comments:
1) Do you think Rogers assertion that even a small gesture like a frown from a child's parent is enough to cause the child to feel less loved is accurate? If so, in what ways could a parent discipline their child that might not cause them to feel less loved? Do you think Rogers would tell parents to simply practice a kind of CCT for childrearing, in other words making them the agents of change rather than the parent imposing "conditions of worth" on them? (Prochaska & Norcorss, pp. 132-133).
2) Miller claims his Motivational Interviewing is "Rogers in new clothes," but this seems a bit simplistic. To be something in "new clothes" would imply that you are nearly identical but just using different words or styles to do the same thing. MI seems very useful, but it does not seem to me to be nearly identical to Rogers. While empathy is a major concern of both as is the use of reflective speech, the fact that it is admitedly "directive" is a definite area of divergence. More importantly, the concept of "developing discrepancy" as a goal of the therapy seems very un-Rogerian. As described by the authors, it seems that discrepancy is the just the client trying to achieve the conditions of worth, not rid themselves of them and self-actualize as Rogers would have wanted. For example, MI was developed for addictive behaviors, but heavy drinking is likely pleasurable for the drinking person at least while they are doing it. Their desire to quit would therefore be motivated not from within, but from their recognition that important relationships in their lives are falling apart due to it. In that case the "more ideal self" would be just another way of saying a person who lives up to their conditions of worth. (Prochaska & Norcorss, pp. 147-148).
Jay Wellman, September 30, 2009.
1)One aspect of Roger’s model of therapy is that the therapist should have “accurate empathy”. This means that the therapist tries to understand the client as if it were their own experiences. The therapist often acts as a mirror for the client. In class, we discussed how the largest part of therapy is who we are or the person of the therapist. Putting these two ideas together, there must be a balance between maintaining our person and also reflecting and empathizing with the client’s emotions. What exactly does this balance look like? (Norcross and Prochaska, 6th edition, pg. 143)
2)I think that Norcross and Prochaska make a valid point when they discuss how client-centered therapy disregards culture and the surrounding environment. Individualism is a large part of the American culture. However, we might be seeing clients that come from a religious or cultural background that does not place high value on the individual. How can we use Roger’s idea of person-centered therapy while still taking into account culture and environment? (Norcross and Prochaska, 6th edition, pg. 161-162)
Lauren Brighton, October 2, 2009
1. Rogers (1961) highlights his personal experience as the most authoritative method of truth discovery: “Neither the Bible nor the prophets- neither Freud nor research- neither the revelation of God nor man –can take precedence over my own direct experience” (p. 24). Experiences are interpretations of events filtered through the grid of one’s worldview – shaped by personal beliefs, culture, environment, etc. If I relied on personal experience as my most authoritative way of knowing, I think I would feel insecure and uncertain all the time. As there are many methods of knowing such as rational discourse, experimentation, hermeneutics and special revelation from God (Entwistle, 2004), do you (classmates) give greater authority to any method(s) when seeking or evaluating truth?
References
Entwistle, D. (2004). Integrative Approaches to Psychology and Christianity. Eugene: Wipf and Stock Publishers
Rogers, C. (1961). On Becoming a Person. Boston: Houghton Mifflin.
2. Genuineness, unconditional positive regard and accurate empathy are valuable therapeutic principles. I imagine they are extended with caution and balance, as too much sharing in attempt to be genuine could lead to over disclosure, too much positive regard could lead to a sexual relationship, and continuous empathetic understanding could lead to counselor burnout. The practice of empathetic understanding, regardless of one’s ability to maintain separateness, is emotionally draining work. I am thankful that the Lord renews and sustains emotional strength (Prochaska & Norcross, 2010).
Melissa Gardner Curri, October 2, 2009
Response to Jay’s post:
On the topic of developing discrepancy in motivational interviewing, you raise an interesting question. Prochaska and Norcross (2010) state, “the person-centered therapist is, in fact, quite directive, but in a subtle and noncoercive style, and only responding to information already in process in the client” (p. 139). As addictive behaviors and addiction-related experiences can be quite threatening for clients to address, could the principle of developing discrepancy be viewed as an extension of the Rogerian therapist’s task to “move the work ahead by empathetically organizing the information from a client’s experience in a concise and accurate manner (Prochaska & Norcross, p. 139)?” Perhaps developing discrepancy could be viewed as another means through which the therapist communicates understanding to encourage client self-exploration (Prochaska & Norcross, p. 141).
1) Through the reading I realized that modern educational counseling curricula places great emphasis on Rogerian technique, namely the use of unconditional positive regard as a rapport-building skill (Prochaska & Norcross, 2010, p. 132, 136). School counselors are required to view all of their students with unconditional positive regard as it is listed as one of the key foundational attributes of a professional school counselor in the ASCA (American School Counselor Association) national model.
2) During a discussion this morning at the breakfast table, my husband, Ed mentioned how physicians use MI (motivational interviewing) for addressing addiction issues and in particular smoking cessation. I found this interesting due to the statement that though MI efficacy in substance abuse is sound, it has not been proven as effective in smoking cessation (Prochaska & Norcross, 2010, p. 150). If we assume the studies mentioned are accurate, why would modern medicine utilize the MI therapy model?
Response to Melissa's post:
I too bristled while reading Roger's (1961) statement that he "could trust his experience" in regards to his practice of therapy and career choices (p. 22). Though I believe very much in the value of experience, I agree with Melissa that if we do not rely on God's wisdom for guidance and ultimately believe in His omnipotence in our lives, we are doomed for disappointment at least and ultimately failure.
Rogers further states his case by saying that "experience, for him, is the highest authority" (p.23). This proclamation led me to believe that not only did he leave seminary and theological study but perhaps he also doubted the validity of religion as a whole?
Amber Blews, October 3, 2009
1. The text mentioned that clients have a tendency to share feelings or emotions of the past rather than what is there at the present time. As the client becomes more comfortable with the therapist (which is achieved through the as therapists show empathy, unconditional positive regard, etc), the client will slowly begin to express what they are feeling at that moment.
I think as Christians, we are caught doing this within our own communities. We share or discuss what sin we struggled with a few months ago or what family issues we had a week ago. We often find ourselves sharing how God brought us out of the sin or how we successfully solved the family issues we had dealt with? It’s so much easier to share what we’ve already gone through because it shows people our strengths and our ability to overcome struggle, rather than allowing our community to enter into the pain we feel at the current moment. We don’t want to look weak or sometimes don’t even want to receive the help. Knowing that I personally get caught in this, I think it will allow me to be more patient with my client as they take time to move from sharing past problems to expressing current emotions. (Prochaska & Norcross, 151).
2. I find it interesting, and a bit ironic, that while the client-centered therapy model emphasizes selfhood and puts high value on individualism, Rogers “rarely managed to individualize his therapy to fit the particular client!” If this model asks us to show empathy and unconditional positive regard towards our clients, what should our attitudes be in order to ensure that what we say or how we help them is unique to each individual? (Prochaska & Norcross, 164-165).
Sarah Moon, October 4, 2009.
Response to Jay Wellman:
I agree to a certain extent that even a small gesture like a frown from a child’s parent is enough to cause the child to feel less loved. It might not be from just that one incident, but the effects of one frown here, an angry tone of voice another day, and a look of disappointment a few days later, all can contribute to make the child feel less loved. I believe that children are affected by their parents’ body language, tone of voice, and actions. Even if the parent’s intention is not to devalue their child, parents are emotional, imperfect human beings that make mistakes. However, I think that the difference between a child that doesn’t feel loved at that particular moment and a child that never has felt loved by their parent is not determined by just one frown. It is determined by the consistent or lack of consistent affirmation and love shown to the child.
1. Self-esteem is centrally necessary to Rogers’s theories; he emphasized increasing the facets through which one can feel positive self-worth rather than trying to increase self-esteem (Prochaska & Norcorss, 141). In doing so one learns to value emotions, virtues, character traits, and personality traits that were initially thought to be unacceptable and shameful. Is Rogers advocating a “truth is relative” approach? Or is he arguing that some emotions or character traits are not inherently immoral but rather socially unacceptable?
2. After reading the quote, “Acceptance of self begets control of impulses” (Prochaska & Norcorss, 143), I wondered if this was a simplistic solution to the behavioral issue of self-regulation. Having experience with anorexia, I have been told that the need for control triggers the behavior. A cause of this need could be the pressure to conform to externally imposed ideals (Prochaska & Norcorss, 143); however, simply learning to accept oneself does not necessarily mean that the person automatically learns self-regulation. While it does deal with a root of the problem, “teachable behavioral techniques have been found to be more effective” in correcting the behavioral issue (Prochaska & Norcorss, 150). This gives the therapist and client more tangible tools with which to learn self-regulation.
(In response to Jay’s first comment)
I do not believe that a frown is capable of making a child feel less loved. A child would be severely insecure if a frown indicated a parent no longer loved them. Lovingly disciplining a child promotes healthy development Baumrind found that children whose parents used an authoritative parenting style were happier, more self-confident and better adjusted than those whose parents used an authoritarian or permissive style (Baumrind, 1967). Also, as a side note, it is important that children assimilate some of the (imposed) values of the society, otherwise how will they know how to function within it?
References
Baumrind, D (1967). Child care practices anteceding three patterns of preschool behavior. Genetic Psychology Monographs, 75(1) 43-88.
1) An aspect of Person-Centered Therapy that really resonated with me was Roger's emphasis on motivating factors behind our behaviors and attitudes towards ourselves. I found this to be consistent with Christ's emphasis on the heart rather than on our ability to live up to certain standards. Since we all "need to be prized, to be accepted, to be loved" we also tend to "act in accordance with the introjected or internalized values of others" (Prochaska & Norcorss 6th Ed, pp.138-139). A lot of times these conditions of worth are placed on us by our pastors, spiritual mentors, congregations, etc...leading to a Pharasaic kind of incongruence. In addition, Rogers spoke only of the conditions of worth placed on us by our parents but there are conditions of worth in every arena of life--sports, school, media, etc...
2) I have been reading a book called "The Art of Intimacy" by Thomas & Patrick Malone (1987) and they mirrored Roger's idea of unconditional positive regard in their work with alcoholics. They found that the therapist and the spouse of the alcoholic must accept the alcoholic both when he or she is sober and when he or she is intoxicated for there to be real and lasting change. This was the exact approach that Prochaska & Norcorss advised for the therapist working with Mrs C (6th Ed., p. 164). Mrs C needed to be loved wether she washed or didn't wash. Again, I find this to be the way that Christ came into the world. "For when we were still without strength, in due time, Christ died for the ungodly." (Rom. 5:6, NKJ).
In response to Amber Blews...
It is amazing how much of psychological theory and practice has been emperically proven to be ineffective and yet used widely across the nation. In an article I read for our regression class, I found that residential treatment centers for delinquent youth utilize a point and level system for behavior modification that has been unanimously proven to be completely ineffective! I think this may be partly because a newer and more effective model has yet to be developed.
1. On page () it was commented that intimacy is therapeutic and therapy is intimate. I was just musing about the implications of that. By now we have all heard a million times about how the intimacy of therapy can go awry (by the therapist sleeping with and otherwise taking advantage of the client) but I was also thinking about how outside of the therapy session this could have horrible implications for a client. If intimacy is therapeutic, then there are healing aspects to say, having a close friend. There are also then, the friends that expect the people close to them to provide a type of therapy that leaves the friendship lopsided, less intimate on one side than one the other. How, as budding therapists, could we prepare clients to not expect that their friends will have the energy or the knowledge to provide therapeutic intimacy for them, and should we think about such a preparation? (Prochaska & Norcross pp. 150)
2. If "meaning emerges from the process of actualizing our tendencies to become all that we are intended to be," and people "with the belief that there must be something more to life than natural living have probably not experienced all that there is to their lives," then there has to be some kind of reconciliation between the person-centered approach and the faith of clients who would seek this approach to help them heal. I suppose that one could say the statement does not apply to people who believe that there is some kind of afterlife which is better than the life here, and that actualization in the sense of being completely satisfied with one's state of being is a slim possibility. I really resonate with much of the person-centered approach, and I think it valuable for people to realize that there is meaning to their current existence, but the way that this is phrased makes me struggle a little. Does anyone have a more eloquent way to rephrase this than I do? It seems that words are escaping me. Prochaska & Norcross pp. 152)
Response to Melissa:
When seeking or evaluating truth, I do allow for methods other than my own experience to guide me. Experience is so powerful because in a way, it is all we really know. The emotions, the memories, the sensations, all of them are compelling, and certainly they play a huge role in my decision making and thought processes; however, I don't think that experience alone is enough. In light of the sin nature we have, in light of findings about the fallibility of memory, and so many other factors, but especially because of my innate fallenness, I don't think I could let experience trump everything. I guess I use a combination of methods, so I would not agree with Rogers, but that combination varies on the circumstance.
Ashley Wilkins Oct 4, 2009
Response to Melissa's first question:
I think to be fair to Rogers, he is claiming his experience is the most authoritative due to its immediacy. He has all the relevant knowledge anytime he conducted research or spoke with a client and does not have to question how information was gathered. He also clearly states his experience is fallible but one of the advantages is that his own experience is easily corrected.
I think the way Rogers means this it is actually commonly how both laymen and scientists behave. Experiments are replicated to try and achieve similar results, in part, because until doing it themselves, scientists cannot be sure all variables were properly controlled. Thus their direct experience is more authoritative than the original researcher.
In a spiritual context, one can preach to you the merits of, or problems with, the gospel, but your own experiences are what are going to govern your decision making process on whether or not to accept it.
According to Rogers and Standal, we “actually learn to need love”. Yet studies have shown that infants who don’t receive enough love or affection will die. Is it possible that we learn to need more love as we grow? Or do we just learn to need a different kind of love? (Prochaska & Norcross p. 143).
Roger’s idea of an ideal intimate relationship includes “unconditional prizing, accurate empathy, and interpersonal genuineness” (Prochaska & Norcross p. 154). If a client is struggling with relationships and is met with the unconditional positive regard of a great therapist, will this affect his/her thoughts on what a good relationship is? For example, say a woman is going to therapy because she and her husband are struggling in their marriage. If the therapist is perfect (in terms of Roger’s ideals), will the client become disillusioned and be frustrated that her husband doesn’t come close to having the therapist’s personal skills? Might this possibly make the marital problems worse instead of better?
Rachael Wittern, Oct 4, 2009
(In response to Ashley) One thing that might help our clients is to teach them about healthy relationships. Perhaps we could explain to them that therapists are different from friends because they get paid to help. Friends are typically willing to be empathetic listeners too, as long as they are “paid” by getting the same treatment in turn.
One concern your post brings up is that sometimes we (the budding therapists) might have the opposite problem- friends who want to leach empathy off of us. Might we become so accustomed to giving and not receiving in relationships that we forget what real intimacy is? I’m guessing that the friendship network of a therapist becomes vital early on in his/her career.
Rachael Wittern
1) Upon reading that a "meta-analysis indicated that the apparent effectiveness of client-centered therapy was largely based on the treatment of problems that occur in academic settings" and that generalizability cannot be made beyond academic problems, I could not help but wonder why/how Rogerian CCT gained such popularity within non-academic settings? Additionally, given its efficacy when dealing with problems in academic settings, what is it about CTT that makes it particularly beneficial within that context?(Norcross & Prochoska, 162).
2)In light of my previous question, I was wondering if perhaps the finding that "one type of outcome measure on which CCT demonstrated higher change than a number of other orientations was in self-esteem..." might serve as a potential explanation for the success of CCT when addressing problems in academic contexts. For it seems reasonable that self esteem might play a significant role in the manifestation of problems within such settings.Then again, what is meant by "problems that occur in academic settings"?(Norcross & Prochoska, 162).
Jessica Nunnally, October 5, 2009
Response to Rachael's first question:
As far as love goes, I think it is possible that Rogers is referring to a different kind of love than that studied with infant mortality vs. thriving research. Rogers seems to conceptualize love more as approval and affirmation that one is loveable/loved. Where as, if I recall correctly from the infant studies, love had more to do with touch and general human contact (affection) rather than the affirmation or disapproval of the infant's behaviors or self. You do make a good point however, that perhaps what one interprets and internalizes as love may change throughout one's development, thus, we may subsequently "learn" to need love in a different or new way after progressing from infancy.
Jessica Nunnally, October 5, 2009
Response to Sarah’s second question:
Sarah, I think what you are saying is that there is a contradiction and I agree with you on this. Dr. Dueck briefly mentioned this in class today. I think that therapy needs to be individualized especially in a culture we live in. First, our culture places a high value on the importance of the individual. Second, we all come from different cultures, ethnicities and religious backgrounds. We must understand our client from their cultural context. Thus, therapy needs to be individualized.
1) Rogers was heavily influenced either positively or negatively by Protestantism. Perhaps his theory of unconditional positive regard arose from the concept of God's grace in Protestantism. It is similar in a sense that a person's value is not judged by what he or she possesses or does, but instead, just the existence of a person alone is of great value (Prochaska & Norcorss, pp. 133).
2) I do not really agree with the vulnerability part of Roger's necessary and sufficient conditions for therapy. He states that "vulnerability to anxiety is what motivates the client to seek..." therapy. Since most people dislike the feeling of being vulnerable, it makes sense that the client is willing to seek therapy to prevent oneself from being vulnerable to anxiety. However, wouldn't seeking therapy make the client replace his or her vulnerability to the therapist instead of the feeling of anxiety?
If the client is wanting to get rid of such feeling of vulnerability, wouldn't the client also be sensitive enough to know that they will make themselves vulnerable to the therapist? (Prochaska & Norcorss, pp. 136)
Response to Lauren Brighton's post:
From my experiences, I find that I often stress my thoughts and feelings more so than that of others; I have a tendency to emphasize myself more than what is necessary. For a therapist, by affirming the client and asking certain question that helps the client to reflect upon his or herself, instead of assuming what the therapist thinks the client feels, it may be possible to establish that balance
Woo C. (Samuel) Kim, October 5, 2009
1)I've always agreed with a lot of the critiques against client-centered/person-centered therapy, namely those listed from the integrative perspective. How are we to use this therapy with clients that have been abused or clients with major personality disorders? That then leads me to ask, as psychologists, do we need to research whether some therapies are only meant for some clients while others are best suited for others? (Prochaska & Norcross, pp. 165-166)
2)Chapter 5 tells us that Rogers seemed to agree with his student, who said that the need for love, or to be loved, is learned. As a Christian, I would argue that the need to be loved is inherent in all of us because God created us so that we may seek Him, and He is love. (Prochaska & Norcross, pg. 143).
Nikki Frederick, 10/05/09
In response to Jay's first post:
As a parent who of course struggles with trying to understand the healthiest and holiest way to discipline children, I would say that it depends on why you're frowning and the context in which you're doing so. God clearly gives us directions as to what is right or wrong, yet also gives us free will and has patience with us. I think a CCT with children may be a great tool if used correctly. Allowing our children to make positive changes and choices, yet loving them regardless, is probably one of the best things we as parents can do for our children.
1) The more I learn about how Carl Rogers revolutionized the field of psychotherapy, the more amazed I become by what a difficult craft his principles must be to practice. For example, several of Rogers' key principles are: Unconditional Positive Regard, Accurate Empathy, and Perception of Genuineness. I find this to be an extremely difficult juggling act. How can a psychotherapist have unconditional positive regard for a client (no matter what they bring to the table) while still maintaining accurate empathy and genuineness? "...the therapist must be seen as genuine and not just playing a role" (Prochaska & Norcross, 137). Becoming a therapist that could sit across from someone who confesses to something vile and disgusting while maintaining a genuinely nonjudgmental empathy is something that I imagine will not only draw on my training in psychotherapy, but my training as a disciple of Christ.
2) William R. Miller's motivational interviewing is very powerful in my estimation. To me, the essential ingredients are the key questions and reflective listening. While maintaining the warmth and empathy as in Rogers' person-centered style (Prochaska & Norcross, 147), the therapist goes an extra step and puts the ball in the client's court so to speak. Without antagonizing the client, the therapist asks questions that empower the client to think deeply about issues and perhaps move toward a resolution which may result in progress. This seems like the type of collaborative relationship that could make for some very quality psychotherapy.
Response To Lauren's #1...
Lauren, I thought the same thing. I am curious as to how this balance can take place. It seems like quite an art form to be able to mirror someone and allow them insights into their own feelings and emotions, while also accurately empathizing with them. Perhaps I am misunderstanding where the balance lies or if they are even taken as literally as I see them, but it seems impossible in my first year PhD mind. I guess that might change with more training and experience...
1)"The person should be the center of his or her meaning, rather than having a meaning imposed by other individuals or society as a whole." (Prochaska & Norcorss, 145).
This statement brings up a couple of issues. First, it seems nearly impossible to apply this approach to the religious who believe in a higher being who provides meaning. Second, even non-religious people who intentify with a culture or community would find this hard to swallow. Finally, this view is at risk for doing the same thing that it seeks to avoid: imposing a self-centered meaning onto the individual.
2)Two of Roger's six requirements for a constructive relationship are genuineness and unconditional positive regard. What happens if the client is doing something that is repulsive to the therapist? Even if the therapist can hold the two in tension (that is, respect and care for the client but also disagree with his actions/thoughts), what if the client doesn't believe it? When is it time to refer the client to a different therapist? (Prochaska & Norcorss, 136).
David Choi, October 5th, 2009.
Response to Rachael Wittern:
Your second point is interesting and seems to echo a criticism from a psychoanalytic perspective (Prochaska & Norcorss, 154). I think the chance is certainly there, but hopefully, the marriage is based on more than positive regard. There should be things (both mundane and special) that the couple loves about each other that go far beyond what the therapist can offer. In addition, one would hope that the therapist was ethical and professional and did not try to woo the client. But it could happen.
1)Prochaska & Norcross said that Carl Rogers surprised them with his candor regarding his ability as a therapist, to be both genuine and nondisclosing. He said that over the years of first working with psychiatric clients and then with growth-oriented groups, he had come to see that his model of a therapist as reflective and nondirective had been very comfortable for a person like him. He said that he had been rather shy and therefore non-disclosing. they also state that right up until his death, Rogers was realizing more fully in psychotherapy and his life, the genuineness he had always valued but never actualized. That being said, do you think if Rogers would have been in therapy earlier in his life and had fully actualized his own genuineness would he have approached the idea of Person-Centered therapy in the same way? If not, what elements do you think would be different? (Prochaska & Norcross, pg. 131)
2) I disagree with the person-centered therapy to impluse control. I think it is over simplified and generalized. It states that once people feel good about who they are and are not under constant stress to be what others want, they will not resort to overeating, drinking, or smoking to feel good for the moment or reduce stress. Acceptance of self begets control of impulses. But what about the scenario where the stressor is ones environment and not necessarily connected to the expectations of others? Also, how should impulse control be addressed if the person does not struggle with low self efficacy? (Prochaska & Norcross, pp.145)
Stephen McGee, October 6, 2009
(Response to Samuel's post)
I too have a bit of a problem with Rogers' view of vulnerablility regarding necessary and sufficient conditions. Although I understand that he regards it as a catylist that helps push someone toward therapy, they are exchanging one form of vulnerability for another. The client has to remain in a state of vulnerability with the therapist in order for the therapy to be effective.
1) Miller's motivational interviewing is a strange thing (Prochaska & Norcross, pp147-150). The strange thing is that it works. At my last job, we would use it to help chronically mentally ill people develop their own motivation to do things in their lives, like shower, or take their meds. While it was personally frustrating at times to deal with client's ambivalence about simple things like teeth brushing or cleaning their apartment, when they decided to do something, the process worked.
2) I am wondering if it is possible to ever truly be self actualized (Prochaska & Norcross, pp147-150). The human being is such that our potential grows as we develop, so that what was our best one day becomes our plateau the next. Is it possible that we as always changing and improving individuals must (to steal a phrase from Winicot) settle with being "actualized enough?"
3) (In Response to Ashley Wilkins) I think the need to reconcile people's faith with the modality of treatment comes about naturally. Because faiths are human creations with divine origins, at some point humans end up making mistakes within the faith. Pastors hurt parishioners, Sunday School teachers embarrass students. What needs to happen for reconciliation is to understand that the way that the representative of the church has hurt them (by harming their self image in the person-centered view) may not be who they really are. Also, I think it is important that your beliefs are separate from the client, so that you can avoid making the same mistakes and become an enabling agent who prevents self actualization through dogmatic adherence to church law.
1. “The empirical justification for therapist self-expression is the discovery that therapists who speak genuinely out of their strong feelings tend to encourage and liberate clients to express their own emotional experiences” (Prochaska & Corcross, 141). This sounds great in theory, but potentially inconsistent in application. Considering diverse backgrounds and various cultural norms, I would imagine all clients would not always respond positively to their therapists expressing their strong feelings. I would think the effectiveness of this approach would vary greatly with the degree of incongruence within the client.
2. “The problem is not that we have too great concepts of ourselves that we cannot live up to; the problem is that our concepts of ourselves are too meager to let us be all that we were born to be” (Prochaska & Corcross, 142). Here, Rogers describes how low self-esteem (self regard) develops in people. Basically, our mind creates a “limit” for us as to what we can be or become and that “created limit” is nowhere near our actual potential. I find this so interesting because I think we sometimes put a limit on God and what He can do.
Response to David Choi:
Very good point David. It seems incongruence may develop in a therapist that is exhibiting unconditional positive regard toward a client that that they perceive as repulsive.
1) I was fascinated by the description of the therapist as a surrogate information processor, helping clients to focus in on and effectively process threatening feelings (Norcross & Prochaska, 2003, pg. 149). In my past studies of person-centered therapy I have never come across such a clear description of how the therapist guides the process of therapy without determining what will be discussed (the content). This helps illuminate for me the therapist's role, expanding it beyond that of a completely nondirective mirror. It seems that in this way the therapist is subtly directing the flow of therapy toward healthy processing, without imposing expectations or confinement upon the client.
2) I also really enjoyed the Rogerian perspective on self-esteem/self-regard (Norcross & Prochaska, 2003, pg. 153). Low self-esteem is seen a result of a narrow self-concept, and interestingly, the aim in therapy is not to increase a person's sense of self-esteem, since this would merely lock the client into a pattern of attempting to actualize a self-concept that is false or limited in the first place, but to expand the individual's conditions of worth, in essence revolutionizing their self-concept in order to truly accept and value who they are and can be as opposed to who they have felt they should be.
Response to Amber:
It's funny that you mention that about our educational system's focus on Rogerian approaches - I was thinking about that throughout the reading as well. I remember learning the term "unconditional positive regard" when I was a very young child, because it was one of the core values of the school district and was taught in each classroom as a way of relating to fellow students, teachers, etc. I think that being taught from an early age to see others from that perspective can be extremely formative and beneficial.
1) Roger’s views on psychopathology reminds me of concept of the reciprocating self (Balswick, King, Reimer, 2005). Individuality is just as important as being in relationships with others; they are reciprocal. Does Rogers place too much emphasis on actualizing forces as motive for a complete self? I think individuality can serve to enhance relationships. Perhaps it does not always serve the individual only (Prochaska & Norcross, pp. 131-133).
2) I wonder how it plays out to always be able to provide unconditional positive regard for a client, even when the client pushing the therapist buttons or even talking about actions that or negative, maybe even dangerous or illegal. I found it difficult to stay “person-centered” women coming into the shelter I worked at would blatantly lie. How to you continue offering empathy and genuineness in this situation? (Prochaska & Norcross, pp. 136-137).
Response to Sarah’s 2nd post:
Your question brought me to Dueck’s integration lecture yesterday where he modeled asking about background and culture of a person. I think it’s important to always remain open to new ways of looking at the world; to especially have a basic understanding of the differences between communal and individualist cultures and what are bias might be toward one or the other.
Rebekah Kilman Liu 10/06/09
"Roger's (1961) ideal for the good life is found in a fully functioning person" (152). The concept of the "fully functioning person" seems synonymous with the essence of a whole person. I find it interesting that Rogers suggests that trust is a significant element to a person's functioning. It is the idea that trusting every experience to be a transformative event that leads to awareness and direction in life. The fully functioning person copes with each experience and can accomplish a "good life" because of their ability to effectively think and act out of the true self. As a therapist, what does this fulfillment look like? Is it perceived as a piecing together of of segments of the self, a realization, a solidification, etc.?
In response to Sarah Moon...
In person-centered therapy, I think a large part of it is facilitating an environment for self-actualization and fulfillment to happen for the client naturally. The process includes the clients themselves to become aware of their uniqueness and individuality. The attitude we may want to have is that of recognizing the experiences of the person and helping that shape their development.
I am wondering if motivational interviewing is shown to be as effective or more so than 12 step programs, why is it not the primary method for treating clients with alcohol dependence/abuse issues. I remember hearing people say that one of the helpful things about AA groups is that the individuals involved have been there and call people on their denial behavior. In contrast, MI "carefully avoid[s] the classic confrontation". This has apparently been shown to be particularly useful for treating resistant clients (Prochaska & Norcross, 2007, 148-150).
(in response to Bobby)
If I understand your comment, you are wanting to learn how to maintain unconditional positive regard while continuing to be genuine even when someone shares something you find appalling.
I conceptualize this by cognitively separating behavior from the person. You can do something bad/evil without it being representative of you as a person. Therefore, in theory, it makes sense to be able to maintain unconditional positive regard for your client while trying to understand what has contributed to them behaving in this way.
1)The author contends that Rogers seems to agree with his student Strandal that we “need to learn to need love” (Prochaska & Norcross, p. 138). While I actually disagree that we to learn to need love, I believe like the author states earlier that the need for love is universal and perhaps we have to recognize that we need love. I wonder, why is it that we cannot recognize that we need love? Does our culture so emphasize independence that we consider love as a competing force for individuation? Do people of other cultures need to learn to recognize their need for love also, or is this more of a Western issue? Or is it more a spiritual issue—that when we learn to recognize our need for love we make roads towards connecting with God, who can ultimately provide us with the level of love our soul craves?
2)I’m interested in the difference between process research and outcome research. It seems Rogers focused his research on the process of psychotherapy. How are both of these used effectively to improve therapy? Both seem important, how the process is conducted and what the outcomes are. And, of course not only the short-term outcomes, but the long terms ones as well. I find myself wondering what sorts of parameters he used to evaluate how the relationship was between the client and therapist. (Prochaska & Norcross, p. 154)
Response to Ashley:
Ashley, I appreciated your comments on the intimacy outside of therapy.
I was considering some similar ideas of what Rogers work implies outside of therapy as I was reading this chapter, for example when the author states, “[Carl Rogers’s] system suggests that anyone who is congruent, whether a peer counselor or paraprofessional, can do effective psychotherapy with all patients and problems, without necessarily having any knowledge about personality or psychopathology.” (Prochaska & Norcross, p.162) A lay person has a lot of power in Rogers’s view. I wonder, in response to your question, how might we be able to encourage clients not to expect too much of friendships, but also help them choose different relationships which will give them different pieces of what they need so they can build healthy and sustainable social networks, intimacy, and positive self regard?
1) The book describes the therapist work as "surrogate information processor" (Prochaska & Norcorss, p 149). I am a verbal processor and I need to get my thoughts out in order to see them. I need an surrogate processor, a person to create the space in which i can safely view my thoughts and reactions. Once this space is created you can begin to see different aspects of the situation. after hearing this description in our reading, me and my inclinations just clicked.
so commenting on Lisa's post. . . i agree lisa, that phrase just clicks and makes sense. and in terms of how you called it a little more directive then the mirror. . . i think instead of being directive, it more or less opens the door allowing them to process, because the threat is less? maybe not.
2) i have never had a class on these things before, so it is my first round of hearing this information. I got really confused when the chapter spends its time describing the client centered therapy, and our class will focus on it, but at the end of the chapter (p163-166) it critiques the theory showing the flaws and making it seem as if this theory should be utilized. how do you weigh such critiques? is client centered therapy not reputable?
1) I find extremely interesting the overlap between the message of Jesus Christ and Roger's theory of counseling. Granted that Person Centered Therapy focuses primarily on the individual receiving unconditional love rather than giving and receiving, but nevertheless the fact that the therapy type concentrates on unconditional love at all is shocking to me (Prochaska & Norcross, 2003, 147). Now that I say that, though, I wonder how this plays out in the room. Does this mean that a therapist should approve of everything a client thinks/does, or that the therapist should simply express care towards the client without "approval?" Can anyone make sense of that?
2) I do struggle with the idea that client-centered therapy may take years to reach any sort of conclusive "ending point" (Prochaska & Norcross, 2003, 158). One of my major concerns is that within a managed-care setting such as much of the United States, open-ended treatment durations are unlikely to receive recognition as viable solutions to mental disorders. However, perhaps client-centered therapy will be better implemented for those clients merely looking to focus on self-esteem and not treat a major mental illness. That is what the therapy has been shown to be most effective for anyways (Prochaska & Norcross, 2003, 162).
(In Response to rwittern)
If I am not mistaking my facts, I do believe that the consensus of the research suggests that women experiencing marital problems should NOT attend individual therapy with a male psychologist. The statistics show that she is actually more likely to ask for a divorce at the end of the counseling regime, than women who seek out a female therapist or no therapy at all. This is a fact that I remember from undergrad, and so I can't give you a citation. Regardless, I found it surprising at the time, and it is certainly applicable for your question.
1)Roger's Person-Centered Therapy is supposedly nondirective because "clients, rather than therapists, direct the flow of therapy" (Prochaska & Norcorss, 5th edition, p.148). The therapist may not direct the topics the client brings up in session, it is still value-laden therapy. Like Dr. Simpson mentioned in class, he gave importance to some topics more than others when he leaned toward the client. The therapist is very directive of therapy through what topics they show the most empathy towards.
2)How does a therapist develop ways to express true empathy to the client? Rogers speaks against "mindless parroting" and "reflection of feeling" (Prochaska & Norcorss, 5th edition, p. 158). In my friendships I tend to show empathy by helping them fully express their emotion and sharing how deeply I connect with what they are saying based on my own similar experience. But the therapeutic relationship is more one sided than a friendship. What is a good way to show true empathy in a therapy setting without too much personal disclosure?
Response to J.B.:
I also see the difficulty in expressing unconditional positive regard in therapy or in a friendship. The term reflects the idea of the unconditional love of Christ that covers our all of our sins no matter what we do. But there is a difference between this kind of love and an approval of all actions that may be seen as a sanction for negative behaviors. Somehow their needs to be the concept of repentance paired with that unconditional love or positive regard.
Jenn Greiner, 10.07.09
1) I appreciate how Roger so simply yet so profoundly states that the importance of therapy rests on the humanity of therapists rather than their technical skills. From a Christian perspective, sin (the ultimate reason for brokenness and the need for healing/restoration) resulted in SEPERATION, from God and from others. As we are also learning in Life Span Development and in our readings in “The Reciprocating Self”, humanity IS being in relationship with God and others. Therefore, simply by regaining that humanity through the client-therapist relationship, it brings healing and restores that person to a greatly needed resource that we were created to be a part of (fellowship, community), regardless of whether or not that person recognizes Christ (Christ is never-the-less the ultimate truth). (Prochaska & Norcorss, pp. 141)
2) I struggle with the tension in the concept of the therapist sharing his or her own experiences with the client. I realize that sharing is a part of being genuine (unconditional positive regard) and creating that relationship but, of course, the client-therapy relationship is ABOUT the client and FOCUSED on the client, therefore, the idea of the therapist sharing experiences has always created a tension for me. How much and what does a therapist share with a client? Under what circumstances? For what reason? Of course there are boundaries and anything that is shared should be to the benefit of the client, but this concept is still such a gray area for me/a boundary that is hard for me to understand, that I am really looking forward to learning more about this concept and discussing it more in class. (Prochaska & Norcorss, pp. 147 & 152)
Kim Richardson, October 7, 2009
Response to Nikki’s comment:
I completely agree with you Nikki that people are born with the innate need to be loved. Studies have shown that children and elderly persons who don’t receive love and attention die quicker and do not have high levels of “thriving.” I agree that God created us to be loved because we were created OUT OF God’s overflowing love. When humanity fell, it separated us from our greatest need, which is God, who IS love, therefore we are all continuously in need of love (reconciliation to our greatest need and the source of the image we were made from). I would argue (or would like to dialogue further about the idea) that because of our fallen nature, we must learn to love and be loved, because we have been so separated from our source of love (God), and that our idea of what love is has been so perverted by our sinful nature, that we must re-learn to be in loving relationships with Christ and one another. Perhaps we can understand this Rogerian concept from this perspective?
Response to J.B.’s comment:
I am also very pulled in the direction of Rogerian theory because of the aspects of unconditional love, relationship, empathy, and genuineness. I believe these elements are at the core of the relationship God wants with us as individuals and what he desires in our relationships to each other. I think that understanding God’s unconditional love is helpful in understanding how that unconditional love towards the client plays out in the room. I don’t think that unconditional love would be to approve of everything the client says or does, because in certain situations approving of what they say or do would not be loving them (example: the client hurting themselves or others). Love requires having (displaying through action) their best interest at heart. Also, I think that expressing care sometimes means using protective measures for that client and challenging them in certain areas. Love and care do not necessarily mean being non-confrontational. This reminds me of our reading this week in “The Reciprocating Self”, in this weeks chapter it explains the concept of God’s covenant (or unconditional love) towards us. When the authors write that “God’s offer is not contractual; Whether Noah or Abraham accepted the covenant or not, God’s commitment was firm” (pg. 54), this seems to resemble the therapists role, in that, the therapists love (unconditional positive regard) is not based on the actions of the client. However, the authors go on to say that “the potential benefits or blessings [the covenant] provided were conditional….[they] had to agree to fulfill their end of the bargain” (pg. 55). In the same way, the therapists actions towards the client change based on the clients actions/willingness to engage in the process even if the therapists unconditional love/positive regard remains the same towards the client no matter their behavior.
1) Rogers believes that there is no true reality and rather that reality is what we experience. With this as a basis, he forges ahead claiming all are born with an "organismic valuing" system. He then assumes that these systems are similar in all people. With no ultimate truth, how can Rogers claim that a somewhat universal valuing system exists? Would this valuing system not change according to culture?(Norcross & Prochaska, p. 138)."
2) In the therapeutic relationship, Rogers states that genuineness is necessary in the therapist. I believe that this is important, however, I believe genuineness requires a good level of self-awareness. Since we change throughout life, how do we, as therapists, remain self-aware? Do we continue seeking psychotherapy for the rest of our careers, or do we learn to be self-intuitive? If so, how would this look? (Norcross & Prochaska, p. 142)
-Candace Coppinger
October 7, 2009
In response to Christie's second question. -
Client-centered therapy is just one approach to psychotherapy. Many different forms exist such as cognitive behavioral therapy, psychoanalysis, etc. Many approaches have great parts, but at times, fail as a whole. By learning about the successes and failures of each approach, we can better integrate these strategies into our own form of psychotherapy.
In response to Nikki's first question.
I also tend to critique aspects of this approach. I think as therapists, it is necessary that we learn the most we can about different approaches to therapy. Every person is different, and therefore, the same approach will not work for all people. I think there are good qualities in this person-centered approach. We should take the good qualities and use them with our clients when appropriate.
-Candace Coppinger
October 8, 2009
1)Roger's believed that all human interactions should be "humanized." I wonder if this desire to make a change is simply a call for the importance and healing power of community rather than the growing individualism present in our western culture. Would religious therapists (who value a faith community) then be better at utilizing this therapy than non-religious therapists? (Prochaska & Norcorss, pp.151).
2)One of the conditions of Roger's therapy is Genuineness, meaning that the "therapists are freely and deeply themselves." However, another condition is Unconditional Positive Regard. How does a therapist justify the treatment of a client that they do not personally like? Is it assumed that therapist practicing this therapy will genuinely like every client they encounter?
Katherine Strong Woods 10/8/2009
In response to Lauren's comment:
I was also wrestling with the genuineness aspect of Roger's therapy. I wonder if the struggle is a part of what makes a therapist a good therapist: someone who can continually ask themselves, "How do I present myself genuinely and relate with this client? How can client an environment to allow this client to be more genuine in who they are."
n response to Jay's comment about directiveness and discrepancy in Motivational Interviewing:
I think the distinction of Motivational Interviewing as directive can be misleading. I would revise that statement within the context of this chapter that it is "relatively directive" as compared to Roger's Person Centered therapy in which clients can choose to focus on any subject at any moment during the session (pg 144, Prochaska and Norcross). Where Motivational Interviewing requires that the therapist focus on the area of behavior change, such as addiction, health behaviors, or other dangerous behaviors, the therapist's attitude still retains the non-directive attitude of the therapist. For example, in response to a client who says, "Drinking a six pack before work might be harmful for others, but it actually helps me stay on my A game, so really, it's better for me to drink while I'm at work than not drink"....the directive therapist might say, "you might feel great, but how do your co-workers and boss feel around you at work?". The non-directive therapist might say, "you feel it's okay for you to drink before work...". Finally, the Motivational Interviewing therapist would say, "It's hard for you to believe that things would improve for you if you stopped drinking at work...". The difference is that while being non-judgemental, and accepting of the client's point of view, the therapist is joining with their point of view and taking their reflective statement one step further towards change. In this example, the therapist is taking the client from feeling comfortable drinking on the job to how they would feel not drinking on the job. Whereas the non-directive (Person Centered) therapist would simply reflect on their feeling (you feel okay about drinking on the job....) without directing their statement towards change. Compared to the classically directive therapist who wants to point out that drinking on the job is negative for all at the workplace, including the client, the motivational interviewer develops discrepancy that already exists for the client: "why is something that is harmful less harmful for me?". Though developing discrepancy seems like the therapist is challenging the client, when done correctly, it is really allowing the side of the client who feels that drinking at work is harmful challenge the side of the client who feels they still need to.
I think the critique of person centered therapy is interesting in pointing out errors in testing its effectiveness, specifically failing to control for a placebo effect. (pg160 Prochaska, Norcross, 2007). I think this could be that it is hard to encounter a therapeutic approach that does not entail at least part of the components of person centered therapy. For example, which therapeutic technique does not utilize some form of warmth and empathy? It is easy to see PCT as obvious, or at least more of a basic framework for all therapy in its utilization of empathy, allowing the client to define their problem and focus issues, and reflecting their truths; however, I think the truer critique is that perhaps PCT is not defined enough to be tested. Specifically, how is it determined that the therapeutic techniques really are Person Centered? It is easy to believe that you are being non-directive at the same time that your attitudes and beliefs are showing through your body language, tone, or focus. So the question becomes, how can we make PCT reliable and replicable so that we can test its effectiveness?
The vignette of Mrs. C (Prochaska & Norcross, pg. 166-167) really struck a chord in me. To see a woman who was cleaning compulsively and nearly rejecting her sick children because of their supposed "dirty" diseased-ness, would be a definite empathy challenge. I think I might be inclined to jump toward trying to deal with a compulsive disorder, instead of empathetically seeing where that may be stemming from. Recognizing where Mrs. C's conditions of worth are clashing and her need to uphold the self-regard she was taught to gain from cleaning is much more important (and probably more effective) than trying to get her to stop cleaning and take care of her sick kids.
2.It was interesting to read the various schools of therapy's responses to Person-Centered Therapy (Prochaska & Norcross, pg 163-165) and to note that the effectiveness of short-term or "brief" series of Person-Centered Therapy has not been studied much (158). Motivational Interviewing seems like a good incorporation of Person-Centered principles. What is the difference? Or are they two branches of the same tree?
Mary Jacobs, October 8 2009
In response to Katherine's second query about whether you can be genuine and CC when you may not particularly like a client... As we discussed in class, I think upholding client-centeredness has more to do with valuing the person as a person and taking their experiences and feelings seriously as they feel them. Not necessarily endorsing everything they think, or supporting any emotion they indulge, but rather to genuinely care for them and genuinely listen to where they are coming from. Caring, valuing, accepting the human doesn't necessarily equal liking, endorsing, etc. Afterall, if you didn't think there were any areas of that client that needed growth, why would they be in therapy?
1. I found it really interesting when the author described how genuine intimate relationships are truly rare because of how hard it is to give to others what we are afraid to admit to ourselves (Prochaska & Norcross, 143). Just how we tend to distort our self-perceptions to fit our self-concept, we also can distort our perceptions of our spouse/partner to fit the conditions of what we deem as worthy of our love (Prochaska & Norcross, 143). This is profound because so often we can blame our partner for something they have done when really all they have done is not fit into to our “conditions of love.”
2. The reading made me reflect on how much of our own self-image is contingent on others. Because of our need for positive regard, we shape our image around what earns us a pleasing response, which then becomes an internalized condition of worth. The author mentions that this desire to earn positive regard is so strong that at times it overpowers our innate desire to become actualized (Prochaska & Norcross, 132). It has caused me to reflect on what conditions of worth I have placed on myself as a result of others.
1. I found it really interesting when the author described how genuine intimate relationships are truly rare because of how hard it is to give to others what we are afraid to admit to ourselves (Prochaska & Norcross, 143). Just how we tend to distort our self-perceptions to fit our self-concept, we also can distort our perceptions of our spouse/partner to fit the conditions of what we deem as worthy of our love (Prochaska & Norcross, 143). This is profound because so often we can blame our partner for something they have done when really all they have done is not fit into to our “conditions of love.”
2. The reading made me reflect on how much of our own self-image is contingent on others. Because of our need for positive regard, we shape our image around what earns us a pleasing response, which then becomes an internalized condition of worth. The author mentions that this desire to earn positive regard is so strong that at times it overpowers our innate desire to become actualized (Prochaska & Norcross, 132). It has caused me to reflect on what conditions of worth I have placed on myself as a result of others.
1. I found it really interesting when the author described how genuine intimate relationships are truly rare because of how hard it is to give to others what we are afraid to admit to ourselves (Prochaska & Norcross, 143). Just how we tend to distort our self-perceptions to fit our self-concept, we also can distort our perceptions of our spouse/partner to fit the conditions of what we deem as worthy of our love (Prochaska & Norcross, 143). This is profound because so often we can blame our partner for something they have done when really all they have done is not fit into to our “conditions of love.”
2. The reading made me reflect on how much of our own self-image is contingent on others. Because of our need for positive regard, we shape our image around what earns us a pleasing response, which then becomes an internalized condition of worth. The author mentions that this desire to earn positive regard is so strong that at times it overpowers our innate desire to become actualized (Prochaska & Norcross, 132). It has caused me to reflect on what conditions of worth I have placed on myself as a result of others.
Rebecca Rouse. October 8, 2009
Oops! Sorry I commented so many times.
The Prochaska and Norcross text discusses the role of the therapist in helping clients process information with the use of language and symbols that are "active, vivid, and poignant" (139). I think one thing that definitely ties in with this, and which is something we have been discussing in many of our courses the past few weeks, is the importance of understanding the client’s cultural context. By having an idea or grasp of the culture, it enables the therapist to create metaphors and colorful examples that are relevant to the client and allowing the client to feel truly understood. Therefore, I believe that a big piece in using language and symbols effectively, is to first have a fundamental understanding of the culture the client is coming from. (Prochaska & Norcorss, pp. 139).
How much of the therapists empathic feedback is verbal and how much is nonverbal? Is there even a distinction? As therapy is client-led, and the therapist acts as a mirror in order to help the client explore their feelings, how much does the therapist interject their own thoughts? If the therapist is speaking and sharing their thoughts, but only minimally, is empathy then something that is communicated non-verbally in expression? (Prochaska & Norcorss, pp. 136-138).
Brittany Rice, October 8, 2009
In response to Hannah Jones:
I agree with Hannah on how conditions of worth are not only placed on us by parental figures, but also by other aspects of our life. For example, our friends, school, significant other, pastor, and the media all place standards on us that need to be met in order to avoid incongruence and anxiety.
In response to Kim: What great integration! (Yes, I just used the buzzword :) I really appreciate how you take Roger’s emphasis on humanity and relate is so clearly to a Christian perspective of sin, brokenness, and healing within the context of therapy. I would add that as we are called to be the salt and light of the earth, that calling can be lived out in the therapeutic relationship by being simply being in relationship with God. The fundamental principles of client-centered therapy, act as tools to aid in this process.
Brittany Rice October 8, 2009
At the outset, person-centered therapy seems elementary, but as I thought more about Rogers' approach of being both genuine and nondisclosing, I realized that this might be more difficult than it sounds. How do we walk that thin line between nondisclosure and genuineness? At this moment, I am having a hard time picturing how that can be done well. I feel that in order to be genuine, one must be honest. (Prochaska & Norcross, p. 137).
"The more conditional the love of parents, the more pathology is likely to develop" (Prochaska & Norcross, p. 139). It seems then that our duty as therapists is as much to work on preventative measures and education for parents as it is to counsel one who has developed pathology due to conditional regard from parents. How, as therapists, can we recognize and live out the duty to preventative care as well as to therapy?
In response to Lauren's first question, I agree that there needs to be a balance. I also wonder when issues of counter-transference enter into "accurate empathy". I feel like that must be a place of such tension, expressing empathy to a client out of your own experiences while not letting those experiences taint the therapy.
Sorry...forgot to leave my name at the bottom of the post.
Heather Patterson Meyer
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